Update on the pharmacotherapy of obesity.
OBJECTIVE
To review recent developments in the pharmacotherapy of obesity, including the agents currently approved for use in the management of obesity and those under development.


METHODS
A MEDLINE search from January 1990 to July 1997 was conducted to identify English literature available on the pharmacotherapy of obesity. The search was supplemented by a review of the bibliographies of identified literature.


METHODS
All controlled and uncontrolled trials were reviewed. When available, double-blind, placebo-controlled trials were used preferentially.


METHODS
Agents were reviewed with regard to mechanism of action, clinical trial data regarding efficacy, adverse effects, pharmacokinetics, drug interactions, and contraindications where information was available. Study design, selected population, results, and adverse effect information were included.


RESULTS
The anorexiants currently available or under development for the management of obesity regulate food intake and satiety via the adrenergic and/or serotonergic pathways. Clinical trials have shown a 10-15% weight loss can typically be anticipated; however, little long-term safety and efficacy data are available. Adverse events tend to be mild and self-limiting, but serious adverse events can occur. Treatment options under development include thermogenic agents, digestive inhibitors, and analogs and antagonists of hormones that regulate food intake and satiety.


CONCLUSIONS
Several mechanisms to control weight are currently under investigation for the management of obesity. Since obesity is a chronic condition, further studies should be conducted to evaluate the long-term safety and efficacy of these agents and the role of combination therapy using different modalities.
Cerulli
J
J
Division of Pharmacy Practice, Albany College of Pharmacy, NY 12208, USA.
Lomaestro
B M
BM
Malone
M
M
D018663:Adrenergic Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D001067:Appetite Depressants / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D001833:Body Temperature Regulation / Q000187:drug effects; D004063:Digestion / Q000187:drug effects; D004347:Drug Interactions; D019358:Fat Substitutes / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D020738:Leptin; D008049:Lipase / Q000037:antagonists & inhibitors; D009765:Obesity / Q000188:drug therapy*; D011506:Proteins / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D018490:Serotonin Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*
D018663:Adrenergic Agents; D001067:Appetite Depressants; D019358:Fat Substitutes; D020738:Leptin; D011506:Proteins; D018490:Serotonin Agents; D008049:Lipase